Quiet diffusion-weighted head scanning: Initial clinical evaluation in ischemic stroke patients at 1.5T.

PurposeTo compare the quality and diagnostic value of routine single-shot, echo-planar imaging, diffusion-weighted imaging (ss-EPI-DWI) to those of quiet readout segmented EPI-DWI (q-DWI) in magnetic resonance imaging (MRI) of acute stroke. Materials and MethodsTwenty-six patients with acute stroke underwent a 1.5T MRI including diffusion-weighted ss-EPI and q-DWI. The two sequences were protocolled to have identical spatial resolution and spatial coverage. q-DWI was tested with (regular q-DWI) and without (fast q-DWI) averaging in 13 patients each. The acoustic noise generated by each sequence was measured. Quantitative and qualitative assessments regarding signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), lesion conspicuity, level of artifacts, overall image quality as well as diagnostic content were performed. ResultsSNR and CNR values of the q-DWI scans were considerably higher than those of ss-EPI DWI (P 0.0078). No statistical difference was found for lesion conspicuity (P 0.125). Statistical differences were found for level of artifacts (P 0.0078) and overall image quality (P 0.002). Both were evaluated better in the ss-EPI DWI than in the regular and fast q-DWI. Apart from one fast q-DWI patient, radiologists voted the images to have the same diagnostic content, with upper 90% confidence limits of 0.238 for regular q-DWI and 0.429 for fast q-DWI. ConclusionIf the acoustic burden is critical to the patient, q-DWI is an equivalent quiet alternative to ss-EPI DWI for use in stroke patients. J. Magn. Reson. Imaging 2016;44:1238-1243.